Retirement Healthcare Plan

Complete this form in order to begin reimbursement, a Claims Activation Form must also be submitted to TIAA-CREF.

Retirement Healthcare Plan Verification of Claims Eligibility (PDF)
[F11291]

Complete this form to activate claim reimbursements for participants who have satisfied the eligibility provision of their employer’s retirement healthcare plan.

Retirement Healthcare Plan Claims Activation Form (PDF)
[F11292]

This form is a plan administrator authorization for a plan participant to begin reimbursement under special circumstances.

Retirement Healthcare Plan Special Circumstances Claims Activation Form (PDF)
[F11290]

If you have questions or need help selecting the correct form, call us at 1 800 842-2776.

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© 2014 and prior years, Teachers Insurance and Annuity Association - College Retirement Equities Fund (TIAA-CREF), New York, NY 10017